james: everything we do in healthcare is innately dangerous. it's sometimes extremely difficult to walk that thin line between health and harm, and you step over it fairly routinely. i have cancer, and life as we have known it is over. brownlee: if you add up medical errors, drug interactions and hospital-acquired infections, medicine itself is the third leading cause of death in this country. of course i don't want to die. i'm paid more when i harm my patients. i'm paid more when i do more, even if it's not beneficial. brownlee: when payment incentives are aligned towards more care, when their worries about defensive medicine are aligned towards giving more care, when their patients seem to want more care, it keeps driving in the same direction towards more, more, more. you do everything you can to preserve life. james: the big entitlement programs-- medicaid, medicare, social security, with the vast majority being medicaid and medicare-- they're on autopilot. they automatically increase year by year. by 2050, they'll be consuming over 70% of